Dr. Stephen J Hartsock
Family Doctor Family Doctor - Sports Medicine
1115 Ronald Reagan Pkwy Ste 148
Avon
, Indiana 46123-6910
Dr. Stephen J Hartsock
Family Doctor Family Doctor - Sports Medicine
1115 Ronald Reagan Pkwy Ste 148
Avon
, Indiana 46123-6910
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Stephen J Hartsock
- 250 N Shadeland Ave Ste 130 - Provider Enrollment
- Indianapolis, IN
- Zip : 46219-4959
- Phone :
Second Address
- Dr. Stephen J Hartsock
- 1115 Ronald Reagan Pkwy Ste 148
- Avon, IN
- Zip : 46123-6910
- Fax : (317) 962-6722
- Phone : (317) 962-8893
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | 01072804A | IN |
| Y | 207QS0010X | Family Doctor - Sports Medicine | 01072804A | IN |
National Provider Identifier
| NPI | 1114938453 |
|---|---|
| Provider Name | Dr. Stephen J Hartsock |
| First Address | Indianapolis, IN 46219-4959 |
| Second Address | Avon, IN 46123-6910 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/08/2006 |
| Last Update Date | 25/03/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 201166240 | (05) | IN |
| 336070768 | CONTROLLED SUBSTANCE # (01) | IL |
| BH8994003 | DEA # (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.